Featured Research

from universities, journals, and other organizations

New surgery may reverse hand paralysis

Date:

June 15, 2012

Source:

University of California, San Diego Health Sciences

Summary:

A reconstructive neurosurgeon has pioneered a novel technique to restore hand function in patients with spinal cord injury. In a delicate four-hour procedure, he splices together tiny nerve endings, only one millimeter in width, to help restore hand mobility.

Share This

Justin M. Brown, MD, reconstructive neurosurgeon at UC San Diego Health System, is one of only a few specialists in the world who have pioneered a novel technique to restore hand function in patients with spinal cord injury. In a delicate four-hour procedure, Brown splices together tiny nerve endings, only one millimeter in width, to help restore hand mobility. Most patients return home 24 hours after surgery.

Related Articles

"Even if a patient appears to have lost total hand function, as long as there is some nerve in the arm or shoulder under the patient's control, some mobility may be regained," said Brown, director of the Neurosurgery Peripheral Nerve Program and co-director of the Center for Neurophysiology and Restorative Neurology at UC San Diego Health System. "With a nerve transfer, the goal is to reverse paralysis. This means achieving functional grasp and release so that patients can eat independently, operate a computer or hold a loved one's hand."

Brown and his team treat hand impairments at cervical level 5 and below. Operating under a microscope, Brown disconnects the damaged nerve and reconnects it to a healthy one. The healthy nerve is taken from underneath the muscles of the upper arm and then connected to a nerve branch that provides finger function. In contrast to muscle transfers, nerve transfers allow whole muscle groups to be restored in the arm without visibly changing the body's anatomy.

"The nerves grow at a rate of 1 millimeter per day," said Brown, who is also founding member and first president of the International Society for Restorative Neurology. "Over a period of six to 12 months, patients can essentially wake up their arms and hands and return to a satisfying level of functionality and improved quality of life."

Brown said that patients occasionally experience temporary weakness where the original healthy nerve is taken. These muscles, however, can recover their original strength. Casting and immobilization is seldom needed after the surgery. He added that the overall result is that multiple hand functions can be restored with a single transplant.

"The recovery of hand function is consistently rated as the highest priority for persons with quadriplegia," said Brown. "While nerve transfers take longer to heal so that axons can regenerate, patients often experience better long-term biomechanical outcomes."

In the United States there are approximately 300,000 people living with spinal cord injuries with 12,000 new injuries occurring each year. More than half of these injuries result in neck-level injures that lead to loss of hand and arm function. Brown said this technique may also be offered in select cases to patients with paralysis as a result of trauma, stroke, or brain injury.

Brown earned his medical degree from the Eastern Virginia Medical School in Norfolk. He completed a surgical internship and neurosurgical residency at Baylor College of Medicine in Houston and a peripheral nerve fellowship in the Division of Plastic and Reconstructive Surgery at Washington University School of Medicine. He was formerly co-director of the Peripheral Nerve Center at Washington University in St. Louis.

University of California, San Diego Health Sciences. (2012, June 15). New surgery may reverse hand paralysis. ScienceDaily. Retrieved March 31, 2015 from www.sciencedaily.com/releases/2012/06/120615141657.htm

Mar. 31, 2015  Increasing state alcohol taxes could prevent thousands of deaths a year from car crashes, say researchers, who found alcohol-related motor vehicle crashes decreased after taxes on beer, wine and ... full story

Mar. 31, 2015  Alcoholism takes a toll on every aspect of a person's life, including skin problems. Now, a new research report helps explain why this happens and what might be done to address it. "The clinical ... full story

Mar. 31, 2015  A new population of 'memory' immune cells has been discovered by scientists, throwing light on what the body does when it sees a microbe for the second time. This insight, and others like it, will ... full story

Mar. 31, 2015  Coronary heart disease and stroke, two of the leading causes of death in the United States, are diseases associated with heightened platelet reactivity. A new study in humans suggests an underlying ... full story

Mar. 31, 2015  A new study had researchers seeking answers to why the therapeutic benefit afforded by SSRIs was so limited in children and teenagers. If researchers can uncover the biological mechanisms preventing ... full story

Mar. 31, 2015  A drug being developed to treat osteoporosis may also be useful for treating osteogenesis imperfecta or brittle bone disease, a rare but potentially debilitating bone disorder that that is present ... full story

Mar. 31, 2015  It is possible to quantify and classify the effects of different diseases on the activity of intestinal bacteria, new research demonstrates for the first time. Human intestinal flora, known as ... full story

Mar. 31, 2015  During prenatal development, the brains of most animals, including humans, develop specifically male or female characteristics. But scientists have known little about the details of how this ... full story

Mar. 31, 2015  A history of depression may put women at risk for developing diabetes during pregnancy, according to research. This study also pointed to how common depression is during pregnancy and the need for ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Related Stories

June 25, 2013  Using a novel technique to promote the regeneration of nerve cells across the site of severe spinal cord injury, researchers have restored bladder function in paralyzed adult rats, according to a new ... full story

Apr. 10, 2013  A new method in which a number of operations are performed simultaneously can provide people with tetraplegia with a better grip function and the ability to open their hand. This method also shortens ... full story

May 15, 2012  Surgeons have restored some hand function in a quadriplegic patient with a spinal cord injury at the C7 vertebra, the lowest bone in the neck. Instead of operating on the spine itself, the surgeons ... full story

Apr. 16, 2010  Spinal injuries are some of the most debilitating that anyone can suffer. However, a new study offers spinal cord damage sufferers some hope. Researchers have discovered that chitosan, a sugar, can ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.